The objective of the CMR competitive renewals is to continue our original aims to continue to collect community-based mammography and pathology data for studying the patterns and outcomes of screening mammography and pathology data for studying the patterns and outcomes of screening mammography practice in North Carolina. Mammography and pathology databases have been developed which allow linking of screening mammography assessments with cancer outcomes. Data is being collected directly from mammography facilities including demographic data, breast history data, reason for and findings on the screening mammogram, data on other radiologic studies necessary to resolve the screening assessment , and recommendations for follow-up. The pathology data from the NC Central Cancer Registry is received on a fast report system (weekly) for pathology diagnosed in 39 counties where the study now is active, and on an annual basis for the entire state. We will also continue our building of a special registry for Native American women, beginning with the Lumbee women in southern NC. This project is part of the National Breast Cancer Surveillance Consortium and has met the data requirements for participation in this group. Additional objectives and a special project that are proposed include: 1 To expand our Native American project: to include a mammography registry for all Native American women in NC; to create a breast cancer registry for Lumbee women; and to test the feasibility of a breast tissue bank for Native American women in NC: 2 To conduct special surveys for collection of risk factor data that becomes of interest over the grant period, as an alternative to expanding the routine data collection in the mammography practices and 3. To continue our study of false negative screening mammography: to establish standards for acceptable rates of false negatives in the community; to understand the causes of missed cancers incommunity practice, and to develop an educational model to use the data from the film review process for continuing education for the participating radiologists. The additional special project is an analytic project to study the effect of variations in practice and radiologist interpretation of breast density on assessing breast density and screening mammography performance.